PATIENT-GRAFT SURVIVAL ANALYSIS IN KIDNEY TRASPLANT WITH DECEASED DONOR IN CHILDREN IN ARGENTINA Bisigniano Liliana MD., López-Rivera Arturo MD., Tagliafichi Viviana, Fernández Víctor J MD., Soratti Carlos A MD.

Introduction Thanks to advances in surgical techniques and immune system suppression, the mortality rate in children with chronic renal failure has dramatically declined. Kidney transplantation has become the standard of care for ESRD in the pediatric population

Objective To analyze the variables included in organ procurement, retrieval and transplantation associated to both patient and graft survival in kidney transplant using deceased donors in patients under 18 years of age.

Materials & Methods The information was obtained from SINTRA for the period The Kaplan-Meir method was used; survival at 30 days, 1, 5 and 10 yrs. was recorded. The Cox regression model was used to consider the variables for both patient and graft survival such as gender and age The MedCalc and SPSS 17 statistical packages were used

Materials & Methods Independent Variables Gender Donor´s Age Recipient´s Age CIT 24 hs Etiology of ERSD Time on Dialysis ( 7 yrs.) Cause of Donor´s Death Mismatch HLA from 0 to 6

Results Survival GENDER345 (54%) FEMALES AND 290 (46%) MALES AGE years MEAN FOLLOW UP4 YEARS (MAX 13 YEARS) PATIENTGRAFT 30 days 99.4%97.2% 1 st year 96.8%91.9% 5 years 91.1%79.3% 10 years 82.5%61.8%

Results Patient Survival Curve 30 days1 year5 years10 years 99.40%96.80%91.10%82.50%

Results Graft Survival Curve 30 days1 year5 years10 years 97.20%91.90%79.30%61.80%

Results Cox regression – patient survival VARIABLEHRIC 95%P Donor`s age years Donor`s age years Donor`s age >60 years--- Recipient`s age >12 years CIT > 24 hrs Obstructive nephropathy Glomerulonephritis Unknown Uremic Hemolytic Syndrome Renal polycystosis Interstitial tubulonephritis--- CVA Anoxia Other cause of coma Tumor < CNS infections--- Time on dialysis >7 years Female recipient Female donor

Results Cox regression – patient survival VARIABLEHRIC 95%P Donor`s age years Donor`s age years Donor`s age >60 years--- Recipient`s age >12 years CIT > 24 hrs Obstructive nephropathy Glomerulonephritis Unknown Uremic Hemolytic Syndrome Renal polycystosis Interstitial tubulonephritis--- CVA Anoxia Other cause of coma Tumor < CNS infections--- Time on dialysis >7 years Female recipient Female donor

RESULTS VARIABLEHRIC 95%P Donor`s age years Donor`s age years Donor`s age >60 years Recipient`s age >12 years CIT > 24 hrs Obstructive nephropathy Glomerulonephritis Unknown Uremic hemolytic syndrome Renal polycystosis Interstitial tubulonephritis CVA Anoxia Other cause of coma Tumor CNS infections--- Time on dialysis >7 years Female recipient Female donor Cox regression – graft survival

Conclusions Female gender as a donor or recipient, a recipient older than 12 and a tumor as the cause of death were associated with a worse survival rate for recipient. The donor´s age between 45 and 59 yrs., the presence of glomerulonephritis as the etiology of renal failure, CIT > 24hrs and time on dialysis >7 yrs. were associated with a lower graft survival rate.

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